NFL

NFL's safety campaign includes rule changes and PR effort

NEW YORK (AP) Jim Gossett has been paid to watch football games for more than 30 years: for three decades as an athletic trainer at Columbia University and four seasons as an injury spotter for the NFL.

But this season, stationed high above the field at MetLife Stadium, Gossett is able to do something he has never done before: Stop the game.

For the first time, the NFL is giving spotters in the press box the power to call a medical timeout. Previously, only coaches or referees could stop the clock.

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It's the latest in a series of changes designed to make this inherently violent sport safer. It's also the centerpiece of a carefully scripted public relations campaign by the NFL, an organization famous for aggressively controlling its image. The message from league executives? Football is ''a safer game than it's ever been.''

''The bottom line here is that the health and safety concerns of players in our game have to predominate over competitive issues. And implementing the medical timeout demonstrates that,'' says Jeff Miller, the NFL's senior vice president of health and safety policy.

Like so much in the NFL's $10 billion empire, the timeout rule intertwines athletics and image. In addition to providing an extra safeguard for players, the rule will help avoid embarrassing incidents like that involving Patriots receiver Julian Edelman in the last Super Bowl. In the fourth quarter, Edelman was dazed after taking a hit clearly visible to TV viewers, yet he remained in the game for several more plays.

The trainer in the press box will now be able to stop the game and notify medical staff to examine the player.

''I think what most people know about being on the sidelines is that it's not the best place to watch a game,'' Gossett says. ''The people at home see more.''

If the story of the new, safety-focused NFL hasn't quite taken off, maybe it's because of how long it took to get here.

For well over a decade the NFL downplayed the risks of concussions and vigorously denied that football could cause permanent brain damage.

Starting in the mid-1990s, a committee of NFL insiders tasked with studying the issue published a string of papers concluding that players faced virtually no long-term risks from head injuries and could quickly and safely return to play. Those assertions are now universally rejected by experts and contradict the league's own safety guidelines.

The NFL's botched handling of head injuries has been recounted in books, magazines, documentaries and was at the center of the class action lawsuit which the NFL paid $765 million to settle last year. And the story is about to get its Hollywood moment.

''Concussion'' stars Will Smith as Dr. Bennet Omalu, the real-life neuropathologist who first identified a form of severe brain damage in deceased football players, a finding that the NFL disputed for years. The picture is scheduled for release Christmas Day.

Today, NFL officials say they are funding medical experts who study the long-term effects of concussions and defer questions about links to brain damage.

''You'll have to ask one of those medical experts to explain what the state of the science is,'' says Miller, a lawyer and former NFL lobbyist.

EXPERT OPINION

Medical experts generally agree that a growing body of evidence suggests repetitive head injuries like those seen in football can lead to neurological disorders, including dementia, depression and tremors. But many questions remain: Why do some players develop these crippling symptoms, while others go on to lead healthy lives? And do concussions alone lead to brain damage, or is it the routine head collisions that occur thousands of times per season?

The nation's leading experts say recent rule changes have made football safer, but they resist blanket statements.

''I'd stop short of saying it's as safe as it's ever been because I think comparing football today to football in the 1960s is very difficult,'' says Dr. Jeffrey Kutcher, director of University of Michigan's sports neurology program. ''But I do see a natural evolution of the game becoming safer.''

Kutcher and others point to several key rule changes, including moving up the kickoff line to reduce returns, when many violent collisions occur. The league has also tried to protect players in a defenseless posture, especially receivers; eliminated virtually all blocks from behind; and installed a far more strident concussion examination and return-to-play protocol.

Some experts say the most important change has been the strict limit on full-contact practices during the regular season, capped at 14. That change was negotiated by the players union in 2011.

But authorities seem to agree the NFL is taking the right approach to studying the problem. Rather than appointing its own expert committees, the NFL has given $30 million in unrestricted funding to the National Institutes of Health, which has independently awarded the money to researchers around the U.S., including some of the league's biggest critics.

ON MESSAGE

As the NFL ramps up its safety messaging it can be difficult to tell where the league's medical policy ends and its public relations campaign begins.

In February the NFL hired Dr. Elizabeth Nabel, president of Brigham and Women's hospital in Boston, to serve as chief medical adviser. One of her first recommendations: More communication, ''so that the public can have a greater understanding of the concerns of the league and what the league is doing about health and safety issues.''

While the NFL talks up safety in the press, it has also been quietly talking to its most powerful potential critics: members of Congress. Just this week the NFL's top lobbyist, Cynthia Hogan, met with House and Senate lawmakers on the NFL's efforts to improve football safety. Hogan previously served as a top lawyer to Vice President Joe Biden.

In July, NFL Commissioner Roger Goodell traveled to Washington to brief lawmakers. These closed-door meetings are decidedly lower-profile than Goodell's last formal appearance on Capitol Hill. At a hearing in 2009, lawmakers grilled the commissioner over his refusal to acknowledge a link between head injuries and brain disease.

''I don't think Goodell and the owners of the NFL have any choice but to address this issue - not because of political correctness - but because without changes we may very well lose this sport,'' says Rep. Tom Rooney, R-Fla., who co-chairs a congressional task force on brain injuries.

FOOTBALL'S FUTURE

If football is truly in danger then ground zero is Boston University, where researchers have identified a degenerative brain disease in 87 of 91 autopsied brains of deceased NFL players. Much is still unknown about the disease, called CTE, or chronic traumatic encephalopathy. It is thought to begin before symptoms appear and involves a buildup of abnormal proteins in the brain that can cause memory loss, confusion and violent aggression.

A similar disease was found in boxers nearly a century ago, but CTE was identified in football players in 2002.

Several former NFL stars have been diagnosed with the disease, including Junior Seau, Dave Duerson and Ray Easterling, all had troubling symptoms and committed suicide. Currently CTE can only be diagnosed through a careful brain autopsy.

Dr. Robert Cantu says the link between head trauma and CTE is growing stronger by the day.

''Every single CTE case in the world's literature - and more than 200 cases studied at BU since 2008 - has involved a history of repetitive brain injury. To me, that's cause and effect. '' says Cantu, a Boston University neurologist and one of the world's pre-eminent concussion experts.

In coming years, Cantu expects animal studies to unequivocally show that CTE is caused by repetitive hits to the head. Once that happens, it will be up to the NFL to decide how to manage the risk.

Cantu envisions a future when NFL players may sign informed consent waivers - much like those used in experimental medical research - acknowledging the health risks of the game and waiving certain legal rights. He believes football will ultimately survive, but the demographics of who plays it will change.

''I think you're going to find that the overwhelming majority will come from a disadvantaged background,'' he says. ''The people that have other options in life are going to take them.''

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AP Sports Writers Dennis Waszak and Barry Wilner contributed to this story